Gina Dorvil, RN

Individual provider Active NPI Registered Nurse · Roosevelt, NY

NPI 1427301985 · NPPES record last updated Oct 22, 2012

Key facts

NPI
1427301985
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
629546 (NY)
Practice address
121 E Greenwich Ave
Roosevelt, NY 11575-1221
Phone
(516) 546-5901
NPI assigned
Oct 22, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
629546NYMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 629546 NY Yes

Addresses

Primary practice location

121 E Greenwich Ave
Roosevelt, NY 11575-1221

Mailing address

121 E Greenwich Ave
Roosevelt, NY 11575-1221
Phone (516) 546-5901

Other providers in Roosevelt, NY

All providers in Roosevelt, NY · Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.